Individual
KENNETH SOWINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
409 E GREENVILLE AVE, WINCHESTER, IN 47394-9436
(765) 584-0480
(765) 584-0470
Mailing address
8840 COMMERCE PARK PL STE E, INDIANAPOLIS, IN 46268-3129
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01044373A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224496
BC/BS
IN
05
—
0189120
—
OH
05
—
200045780
—
IN
Enumeration date
05/27/2005
Last updated
10/16/2014
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